title: Pion irradiation at Paul Scherrer Institute. Results of dynamic treatment of unresectable soft tissue sarcoma.
abstract: Since November 1981, when pion irradiation was introduced for deep seated tumors at the Swiss Institute for Nuclear Research (SIN; now Paul Scherrer Institute, PSI) a dynamic, three-dimensional spot scan application technique has been in use. To exploit this technique a special planning system for optimisation of the dose distribution has been designed. From November 1981 to December 1988 a total of 406 patients have been treated with pions. From April 1983 to October 1987 a total of 35 patients were prospectively treated for unresectable soft tissue sarcomas in a phase I/II-study. In 32/35 patients, tumor sites were retroperitoneal, pelvic or in the groin or thigh. 27 patients received a high, curative total dose of 30 to 36 Gy. After a median follow-up time of 19 months (13 to 68) the actuarial five-year rate of local tumor control for these 27 patients was 64%; the actuarial five-year survival rate of the 20 patients treated without metastases was 58%. Late reactions appeared in 5/27 patients: 2/8 patients with extremity/groin sarcomas (1/2 caused by biopsy) and 3/19 patients with retroperitoneal/pelvic sarcomas (one a skin reaction after Actinomycin-D, one a small bowel reaction after 36 Gy, a dose no longer given). Dynamic spot scan pion irradiation proves to be a successful treatment technique for unresectable sarcomas with a high rate of tumor control and a very low rate of severe late reactions.
authors.affiliation: Paul Scherrer Institute, Department of Radiation Medicine, Villigen, Switzerland.
authors.forename: R
authors.initials: R
authors.lastname: Greiner
authors.forename: G
authors.initials: G
authors.lastname: Munkel
authors.forename: R
authors.initials: R
authors.lastname: Kann
authors.forename: H
authors.initials: H
authors.lastname: Blattmann
authors.forename: A
authors.initials: A
authors.lastname: Coray
authors.forename: P
authors.initials: P
authors.lastname: Thum
authors.forename: A
authors.initials: A
authors.lastname: Zimmermann
mesh_terms: D000368:Aged; D002648:Child; D004601:Elementary Particles; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008651:Mesons; D011879:Radiotherapy Dosage; D012509:Sarcoma / Q000401:mortality / Q000532:radiotherapy*; D012983:Soft Tissue Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D013997:Time Factors